Fauquier Hospital Leads the Way with Newborn Screenings

July 19, 2012

Eight out of every 1,000 newborns have some form of congenital heart disease, making it the most common birth defect. If the condition is not detected before the baby leaves the hospital, critical congenital heart defects (CCHD) can result in sudden death or require emergency surgery in the first few days and weeks after birth. Understanding the importance of early detection, Fauquier Hospital instituted a new screening for CCHD last November.

Virginia Gov. McDonnell recently issued an executive order directing the Virginia Department of Health to develop a plan for implementing statewide newborn screening for CCHD in hospitals. Fauquier Hospital provides a perfect example for other medical facilities.

Amy Powers, RN in Fauquier Hospital’s Family Birthing Center, has been involved in the project from the beginning, reviewing the research and working with experts at Children’s Hospital in Washington, D.C. to bring the screenings to Fauquier. She said, “We saw that other states were requiring the screening, and when we looked at the research, it was overwhelming. With support from our administration, clinical staff and pediatricians, we decided to go ahead and make it part of our standard of care.”

The Fauquier Hospital’s Family Birthing Center screened 442 infants between November, 2011 and May, 2012. Powers said that the key to the program’s success is an ultra-sensitive pulse oximeter that substantially reduces false positive readings; the pulse oximeters cost about $3,000 each. “Because the Massimo Pulse Oximeter we use provides very accurate readings, pediatric cardiologists are called in only when necessary, easing the process for pediatricians, heart specialists and the hospital,” she said.

The non-invasive test is administered at the same time as regular newborn hearing screenings, takes 30 seconds to do, and has become a seamless part of Fauquier Hospital’s routine. The pulse oximeter is placed on the baby’s right hand and on one other extremity. It measures the amount of oxygen in the baby’s blood. If infants do not pass with a healthy percentage the first time, they are given the test again an hour later and if necessary, an hour after that. If a child fails the screening three times, the pediatrician is contacted and usually, a pediatric cardiologist is consulted. So far, eighteen babies have had to be rescreened once and one a third time, but all have passed within the required time.

Dr. Wesley Hodgson, OB/GYN with Fauquier Health OB/GYN, says that congenital heart disease is discovered prenatally, through ultrasound, only 23 percent of the time. “Parents think these kinds of birth defects can always be detected through ultrasound, but even though ultrasound technology has come a long way, CCHD is usually found after the baby is born.

“It’s a very common birth defect. Examination of a newborn by a pediatrician reveals the problem about 50 percent of the time, when the child has other symptoms. The screening that the hospital began doing in November will help us to find the defect in babies that present no other symptoms.”